Improving service quality and efficiency
— Report on the evaluation of the style of the clinical pharmacy department of the Department of Pharmacy
One hundred years of vicissitudes, Henan Provincial People’s Hospital has inherited a deep historical deposit, a hundred years of precipitation shaped the hospital’s excellent tradition. Our hospital’s continuous years of hospital style review, initially curbed the momentum of the rapid growth of patients’ medical costs, effectively alleviating the patient “difficult to see, expensive to see” problem. In recent years, the governance of the field of pharmaceutical procurement and sales of unethical wind, is an important task of the health system to correct the wind. With the general promotion of microcomputerized management of drug purchase and sale information, the number of links of the unified prescription has increased and the means of unified prescription has become easier, and the difficulty of governance has also increased. Under the correct guidance of the hospital leadership, all members of the clinical pharmacy fully understand that: to strengthen the construction of medical ethics and medical style, we must always adhere to the “Three Represents” important thought as a guide, always put the interests of patients in the first place, closely focus on improving service attitude, improving service quality, controlling medical costs, reducing the burden of patients, and eliminate Receiving rebates, “red envelopes”, billing commission and other unhealthy wind, to provide patients with higher quality, lower cost of medical and health services, and build a harmonious doctor-patient relationship. In order to achieve these goals, in practice, we have taken the following measures: Henan Provincial People’s Hospital, Department of Pharmacy Zhao Ningmin
First, strengthen education and learning
Thought is a guide to action, what kind of thought there is what kind of action. Only from the ideological truly aware of the importance of medical ethics and medical style, in order to truly achieve all the patient-centered, wholeheartedly serve the people. We through the hospital weekly meetings, department meetings, group meetings, party members will, publicize and study the medical reform policy, establish the reform no matter how deep, how the situation changes, the purpose of serving the people can not change, the medical staff to save lives and help the injured humanitarian moral concept can not change, “patient-centered” thinking can not change, medical quality, medical safety, the position of integrity first can not change. The position of medical quality, medical safety and integrity first cannot be changed; actively circulate the “Chinese supervision”, “clean government centralized education month study materials” and other related materials, study hard, seriously understand, enhance the ability to resist unhealthy wind; seriously study President Ma, Secretary Cai in the mobilization meeting of the style of practice evaluation We also study the spirit of the speeches of President Ma and Secretary Cai at the mobilization meeting of the evaluation of the style of practice, study the relevant provisions and requirements of the special work of the fight against commercial bribery, and study the relevant deployment and requirements of the democratic evaluation of the hospital style of practice. Through education, strengthen the “patient-centered” service concept, strengthen professional ethics, professional discipline, professional responsibility and good traditional style education, strengthen doctor-patient communication, and establish a healthy and harmonious doctor-patient relationship.
Second, to carry out self-examination and self-correction work
A check of the sense of enterprise. To see whether the motivation and enterprising spirit is strong, whether the lack of enthusiasm for entrepreneurship, whether the habit of traditional thinking to think and do things, whether the subjective initiative is strong; to see whether the political learning is going through the motions, whether to meet only half knowledge, or find excuses not to participate in learning, or learning as a window dressing, learning no spiritual basis, no self-transcendence of the realm, that learning and not learning the same; to see the cause Whether there is the pursuit of ambitious ideals, whether the “no fault is merit”, used to follow the order of things, stick to the rules, is active to find things to do, or passive and so on, whether the work is forward-looking, whether the work position as a port of call.
Second check the sense of responsibility. To see whether the strong sense of enterprise and responsibility, whether to treat the work of numbness, just to get by, not to get by, the standard is not high, the requirements are not strict and other phenomena; to see whether the work style is lazy, not sinking, sitting down, negative fear of difficulties, shirking responsibilities, fear of responsibility, figure idle, not practical, fear of trouble, cope with the phenomenon; to see whether there is inefficiency, in the post is not dedicated, dedicated to the problem of not professional.
Three check the sense of discipline. Look at organizational discipline, discipline consciousness is not high, strong sense of obedience is not strong, the task set by the higher organization or make the decision to carry out is strong, there is no order, there is a ban, arbitrary, I do what I want phenomenon; look at the work discipline, whether there is not in accordance with the requirements of the system, how the work wants to engage in how to engage, arbitrary, by their own feelings to do things, care about this and that, the work is not in the state Whether there is late to work, leave early, work time to do personal business, or do something unrelated to work, or even do not go to work for no reason; to see the integrity of discipline, whether the sense of integrity and self-discipline is strong, whether there is the unit of power personalized, the power of the position of interest, the existence of food, take, card, want, newspaper, and other phenomena.
Four check the sense of service. To see whether there is a door difficult to enter, face difficult to see, difficult to do the phenomenon; to see whether the lack of work art, simple methods, domineering attitude and other phenomena.
Third, standardize the rationalization of clinical drug use
The clinical pharmacy actively responds to the call of the Party Committee of the hospital, and actively does a good job in rationalizing the use of drugs. In the actual work, certain achievements have been made, but there are also many tasks to be strengthened. In 2011, the clinical pharmacy department mainly did the following work in rationalizing the use of drugs.
(1) Conscientiously implement five systems such as rational drug use training system, antibacterial drug hierarchy management system, clinical pharmacist room inspection system, prescription review system and rational drug use monitoring, reporting and evaluation system. Actively promote medical record review and prescription review, and actively supervise the rational use of clinical drugs. No less than 30 medical records and no less than 100 prescriptions are reviewed each month. Sample medical records are checked and antibacterial drug use survey forms are filled out, with each form signed by the person filling it out to ensure that the data is true and credible and the evaluation is justified. The data is entered into the database of the antimicrobial drug monitoring network, and the analysis is regularly organized and written out.
(2) Conscientiously implement the Ministry of Health’s Guidelines for Clinical Application of Antimicrobial Drugs, the Notice on Strengthening National Monitoring of Rational Drug Use and the Notice of the General Office of the Ministry of Health on Issues Related to the Management of Clinical Application of Antimicrobial Drugs, and actively carry out education on rationalization of drug use so that individualized and rationalized drug use is deeply rooted in people’s hearts.
In 2011, the clinical pharmacy department published 10 articles or articles accepted by conferences.
(4) Actively carry out blood concentration monitoring of phenobarbital, carbamazepine, phenytoin sodium, sodium valproate, digoxin, tacrolimus, etc. The monitoring volume has doubled on the original basis, and is becoming a platform for individualized drug use with more complete therapeutic drug monitoring items, larger monitoring volume and more standardized operation in the province.
(5) Actively carry out the collection, collation and reporting of adverse drug reactions, and report more than 200 adverse reaction reports in 2011, which has been praised by provincial and municipal adverse drug reaction centers for many times.
(6) Actively promote the participation of clinical pharmacists in the room inspection system and actively participate in clinical consultation and discussion of death records. The clinical pharmacists actively participate in clinical check-ups, consultations, difficult case discussions and clinical medication supervision, and attend more than 40 in-hospital consultations to provide professional technical support for the rational use of medication by physicians. There are five clinical pharmacists who have been in the front line of clinical practice for a long time, providing doctors with medication guidance and patients with safe medication consultation services, and effectively monitoring the whole process of patient medication.
(7) Organize the preparation of “Clinical Pharmacy Newsletter (Quarterly)”, striving for informative, innovative and original contents. Organize the preparation of “Clinical Pathways of the Ministry of Health” to promote the management of clinical pathways. Organize and summarize the preparation of “Clinical Medication Guide of Henan Provincial People’s Hospital” to provide reference for rational clinical use of medication and provide reference for pharmacists under clinical.
(8) Actively participate in the hospital’s evaluation of the rationality of medication use for the top ten drugs in terms of sales amount and its top ten physicians in terms of medication use, and provide technical support to effectively curb the ratio of drug revenue to total revenue.
(9) Actively carry out pharmacokinetic studies to provide first-hand information for the clinical application of new drugs. Complete cefdinir bioequivalence study and citalopram bioequivalence study.
(10) Prepare the basic drug catalog of Henan Provincial People’s Hospital with reference to the national basic drug catalog and the provincial basic drug catalog and update it regularly; prepare the prescription collection of Henan Provincial People’s Hospital with reference to the national prescription collection and update it regularly.
(11) Actively develop new thinking and methods, and use new ideas to strengthen rationalized medication management. In the officially operated new information management software (Neusoft hospital medical advice management software), the software can integrate prescription and case automation audit system, which can automatically review the prescription and medical advice in the problem of unreasonable use of drugs and provide rationalization suggestions. However, the software is not written by our hospital, so it is inevitably “unsuitable” and impossible to maintain individualized rational medication use according to our hospital’s specific conditions. The Clinical Pharmacy Department of the Department of Pharmacy actively undertakes the maintenance and updating of the rationalized medication system in the information management software, and strives to create a set of rationalized medication supervision software tailored to the specific conditions of our hospital. The adoption of information technology system to manage rational drug use will be the trend and has unparalleled advantages of traditional mode. The whole process of informationization and automation of rational medication management will greatly improve the level of rationalized medication in our hospital, stop unreasonable medication in advance at the stage of medical advice, and solve the problem of unreasonable medication in the nascent stage.
Medical quality is the lifeline of hospital survival and development, and is the eternal theme of hospital management; rational drug use is an important part of hospital medical quality; strengthening and improving the management of clinical drug use is an effective intervention measure to improve the level of rational drug use; the clinical pharmacy will resolutely implement the guidelines and policies of the Ministry of Health and the Party Committee of the hospital, strengthen drug supervision, and strive to promote rationalized and individualized drug use.
Fourth, actively promote the special rectification activities of clinical application of antibacterial drugs and regulate the rational use of clinical drugs
In order to further strengthen the management of clinical application of antibacterial drugs, promote the rational application of antibacterial drugs, effectively prevent and control the spread of bacterial drug resistance, and ensure medical quality and medical safety, according to the “National antibacterial drug joint rectification work program” (Health Medical Administration issued [2010] No. 111) and “2011 antibacterial drug clinical application special rectification activities program” (Health Office Medical Administration issued [2011] No. 56) documents From 2011 to 2013, we will carry out special rectification activities for the clinical application of antibacterial drugs in the whole hospital.
The Office of Clinical Pharmacy is responsible for some of the specific work of the special review of antibacterial drug prescriptions and medical orders. In 2012, we completed about 1,115 evaluations of rational drug use in medical records. (1) Focus on sampling clinical departments such as general surgery, respiratory medicine and interventional medicine. Randomly selected 148 medical records of 20 wards including neurosurgery, general surgery, breast surgery, cardiac surgery, cardiology, hemangioma and orthopedics that were not discharged on the same day for special review of perioperative prophylactic use of antibacterial drugs for class I incision surgery; randomly selected 226 medical records discharged from January to June from respiratory department and 236 medical records discharged from January to June from interventional department (including cerebrovascular disease group, (including cerebrovascular disease group, peripheral vascular disease group, malignant tumor and non-vascular disease group) for retrospective investigation and analysis. (2) The evaluation and analysis found that there were more unreasonable phenomena: inappropriate drug selection; surgical prophylaxis in preoperative >2h or preoperative unused postoperative medication; prolonged prophylaxis for class I incision and long course of treatment; a few interventional departments used cephalosporin prophylaxis for contrast surgery, which belonged to unindicated medication. For the unreasonable prescriptions and medical orders found, they were reported to the Clinical Rational Drug Use Supervision Group to instruct relevant rectification. We strongly promote the special treatment of antibacterial drugs in our hospital, effectively control bacterial drug resistance, and guarantee the medical quality and medical safety of the hospital.
Antimicrobial drugs are used in large quantities, and the reasons for this are related to drug companies using various ways to promote drug sales. Antimicrobial drug regulation is imperative for the benefit of the country and the people.
V. Establishment of rules and regulations
Medical ethics and medical style construction is the medical staff from the ideological, behavioral and style of regulation and restraint. To ensure that such norms and constraints on the medical staff to occur, it is necessary to monitor and develop incentives and penalties. We carry out monthly self-examination and self-correction, monthly warning education, monthly fill out the “monthly investigation report of the style of practice” and submit to the higher leadership, and strive to find the problems and hidden dangers in the work.
Sixth, carry out patient surveys
Investigation and research is our party’s fine tradition, without investigation there is no right to speak, medical ethics and medical services, only the patient has the most right to speak. We do not regularly solicit patients’ opinions, and do not avoid or take sides in the problems that arise in the work, and do things strictly according to hospital policies.
Seven, strict fee management
This year, the focus of the work of medical ethics and medical style is still the governance of indiscriminate charges, and strive to provide quality services for patients. We strictly implement the hospital policy, strictly enforce the national charging prices, do not decompose charges, do not charge indiscriminately.
Eight, vigorously promote the spirit of “saving lives and helping the injured, love and dedication”
We advocate the treatment of rich and poor are treated equally, especially to care for the needy and vulnerable groups, truly reflecting the warmth of the socialist family. We give priority to special patients in monitoring, and use free SMS notification to inform patients in the field of their blood concentration monitoring results. At the same time, we actively participate in the various donation activities of the hospital and offer love to the society.
We strengthen the word “strict” and escort the construction of spiritual civilization with noble professional ethics and excellent industry style. As the same service window and the same contact with patients, the clinical pharmacy is probably the department with the fewest complaints in the pharmacy department. Although we have less contact with patients, it is also related to the individualized service we provide for patients. There is only one value on the blood concentration test report, but it covers a lot of information, and rationalized medication guidance can only reach patients’ requirements. Clinical pharmacists in the Clinical Pharmacy Office work on the front line of the clinic, and our clinical pharmacists do not use the convenience of their work to promote drugs to physicians, nor do they accept red packets and kickbacks from drug marketers. The pharmacists in the clinical pharmacy did not accept any manufacturer’s red packets and kickbacks with the right to participate in the rationalization of the hospital’s medication management, and acted strictly according to the standards of the party members and in strict accordance with the hospital’s policies. There are no drug dealers hovering outside the door of the clinical pharmacy.
Material civilization and spiritual civilization are the two wings of human soaring, one cannot be without the other. We must not let the beacon of spirituality and morality grow dimmer and dimmer under the glitter of material civilization.
Department of Pharmacy, Henan Provincial People’s Hospital, Department of Clinical Pharmacy
Zhao Ningmin